Point of View

Political ideology has become a crucial indicator of population health outcomes

December 9, 2021

Historians claim that the level of polarization in the US currently has not been seen since the 1860’s American Civil War. We see it manifesting in anti-science behaviors like not masking or being vaccinated against COVID-19, increased anxiety levels leading to a mental health epidemic, and escalating racism. These societal fissures reflect many things, including the lifestyle and health choices we are making.

Healthcare enterprises across the ecosystem, including self-insured employers, have an opportunity to play a leadership role in their communities to help mitigate the polarization. Given the Centers for Disease Control and Prevention (CDC) data shows political ideology has at a population level, correlation to health outcomes. Healthcare enterprises must incorporate psychographic analytics (attitudes, values, interests) to augment other clinical and administrative data in fundamentally changing their communities’ level of intervention and engagement. Service providers have a chance to enhance their data and analytics capabilities to provide critical population insights that can aid in making better choices with lifestyles and nutrition.

In this perspective, we map the political affiliation of most US states against their population’s activity levels, nutritional choices, obesity levels, life expectancy, and Covid deaths. This paints a vivid picture of the correlation between ideology and health outcomes.

A body in motion remains in motion

Leisure-time activity generally includes exercise of various types (aerobics, weight training, cardio). These activities have a positive impact on humans’ overall health, which includes prevention of disease conditions, a better mental state, and longer life expectancy.

At a population level, states with a democratic affiliation (blue) have a distinctly higher propensity for physical activity than states with a republican affiliation (red) whose propensity for no exercise is particularly high.

Exhibit 1: More red state adult population engage in no leisure-time physical activity

Source: CDC (2019 data), Gallup 2017 political map, HFS Research

An apple a day keeps the doctor away; red states did not get that memo

The ancient Greek philosopher Hippocrates apparently said that “all disease begins in the gut”. Modern science agrees with that given there is overwhelming evidence that nutrition is a key puzzle piece that contributes to an individual’s overall health.

There is positive data to indicate that there is a level of consistency and unity across the US when it comes to vegetable consumption. Everyone appears to want to hold their nose and eat their broccoli. However, that unity disappears fast when it comes to fruits. Populations in blue states appear to enjoy their fruit compared to the populations in red states.

Yet, there is no clear indication as to the divide with fruit or vegetable intake given there are no access, cost, or other barriers for one over the other.

Exhibit 2: Vegetable consumption seems consistent across ideologies, but blue states do like their fruits

Source: CDC (2019 data), Gallup 2017 political map, HFS Research

Kale may not appeal to all but some of it may help you fit in your pants

The good news is that there is a level of unity to vegetable intake, that is if you think potatoes are vegetables. And maybe red states do believe that given that the obesity levels are significantly more than blue states. While this is not suggesting a war against potatoes, there is a correlation between dietary choices and activity levels to the overall weight.

The obesity levels trend 5 basis points higher from blue to red states across their populations. That is a cry for action, given obesity is one of the primary drivers of cardiovascular diseases and other comorbidities.

Obesity as a chronic condition is an enormous expense for states to manage and can be a significant burden for development dollars to be repurposed. Targeted mitigation flanking chronic conditions with ideological data can address health challenges at an emotional level.

Exhibit 3: Adult obesity rates correlate with nutrition and activity levels

Source: CDC (2019 data), Gallup 2017 political map, HFS Research

Population life expectancy is a function of overall quality of life

It is easy to connect the dots from activity to nutrition to chronic conditions to the impact on life expectancy. At a population level those states that have a lower sedentary lifestyle, and consume fruits and vegetables have lower levels of obesity. These journey points appear to conclude in higher life expectancies as well.

The linear trend of life expectancy between blue states and red states shows an almost 2-year difference; that translates to blue state populations living 2 years longer than red states. At a rate of $100 thousand to $200 thousand per year of life, a consensus of most health economists, red states have an intrinsic economic disadvantage that can run into billions of dollars in lost financial productivity.

Recognizing the numerous drivers to life expectancy, the whole human approach is no more academic. Those in the business of engagement and experience and those responsible for our healthcare must incorporate ideological vectors in addressing gaps in life and care.

Exhibit 4: Americans in blue states are living longer than those in red states

Source: CDC (2018 data), Gallup 2017 political map, HFS Research

Human losses are a measure of the efficacy of any pandemic response

The US response to COVID-19 has been a quilt of various approaches, from strict lockdowns, mandated masking, and vaccination to not even admitting that there is a deadly virus amongst us. The blue states saw lower deaths due to their science-biased mitigation while the red states chose to tough it out and lost more lives.

The pandemic has highlighted that ideology also impacts health policy at a population level, its communication, and execution. The results thanks to the CDC are public data that allows those willing to learn from it plenty of lessons. Key learning in a free society is that politics will play a large role in people’s choices, so it is important to bake that into the design and delivery of solutions. It’s often a matter of life and death.

Exhibit 5: Covid-19 killed materially more in red states

Source: CDC (deaths as of Oct 26, 2021), Gallup 2017 political map, HFS Research

The Bottom Line: Ideology significantly impacts individual choices and health outcomes, and so healthcare providers must not be shy in pursuing psychographic signals to help individuals manage their health and healthcare.

While the data is at a population level, it reflects individual choices and outcomes. Healthcare enterprises must address these choices and outcomes by incorporating consumer political ideology amongst other vectors to increase healthy outcomes. The new definition of political correctness is recognizing where you stand, healthy and long life or a sick and short one.

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